title: Reproductive outcome after methotrexate treatment of tubal pregnancies.
abstract: OBJECTIVE
  To evaluate subsequent pregnancy outcomes in women who have been treated with methotrexate for tubal pregnancies.
  
  
  METHODS
  Descriptive study of subsequent pregnancy outcomes in 170 women who were treated with methotrexate for tubal pregnancy at Brigham and Women's Hospital during 1989-1994. Patients who agreed to participate were administered a telephone interview. Fertility rates and outcomes were calculated for patients who tried to conceive after receiving methotrexate.
  
  
  RESULTS
  One hundred four of the 170 women with tubal pregnancies identified during the study period returned their consent forms. The other 66 patients were either unable to be reached by phone, and/or their consent form was returned without a forwarding address. Ninety-four patients (90%) agreed to participate in the study. Eighty-two (87%) women tried to conceive after receiving methotrexate for their tubal pregnancies, and 57 (70%) were successful. Forty-six (81%) of the 57 women experienced intrauterine pregnancies, and 11 (19%) had recurrent tubal pregnancies. When the first subsequent postmethotrexate outcome was examined, there were 26 (46%) term births, 5 (9%) preterm births, 11 (19%) recurrent ectopics and 15 (26%) spontaneous abortions. Over the six-year study period, 42 (74%) women had at least one live birth. There were no congenital anomalies or stillbirths in the subsequent pregnancies.
  
  
  CONCLUSIONS
  Pregnancy outcomes after methotrexate treatment for tubal pregnancy are comparable to reported experience with surgical therapy. Patients who are treated with methotrexate for tubal pregnancies can be assured that their methotrexate exposure should have no untoward effects on subsequent pregnancies.
authors.affiliation: Department of Obstetrics and Gynecology, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts 02115, USA.
authors.forename: K A
authors.initials: KA
authors.lastname: Keefe
authors.forename: J S
authors.initials: JS
authors.lastname: Wald
authors.forename: D P
authors.initials: DP
authors.lastname: Goldstein
authors.forename: M
authors.initials: M
authors.lastname: Bernstein
authors.forename: R S
authors.initials: RS
authors.lastname: Berkowitz
mesh_terms: D005260:Female; D005493:Folic Acid Antagonists / Q000009:adverse effects / Q000627:therapeutic use*; D005500:Follow-Up Studies; D006801:Humans; D008727:Methotrexate / Q000009:adverse effects / Q000627:therapeutic use*; D011247:Pregnancy; D011256:Pregnancy Outcome; D011274:Pregnancy, Tubal / Q000188:drug therapy*; D012189:Retrospective Studies
chemical_list: D005493:Folic Acid Antagonists; D008727:Methotrexate